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This produced estimates of the probability that the intervention was cost-effective using several thresholds of willingness to pay for a QALY.
A cost-effectiveness acceptability curve was created to determine whether implementation of DCP was cost-effective given different thresholds of willingness to pay for QALYs (e.g., a threshold of €20,000 per QALY).
The highest probabilities of cost effectiveness were for the two SF-36 outcomes from the societal perspective, for which probabilities were high even at low thresholds of willingness to pay for extra point gains (fig 1).
The CEAC shows the treatment (active or placebo) with the highest probability of being cost-effective at varying thresholds of willingness to pay for a unit of outcome, and is a means of expressing uncertainty around point estimates [ 27].
A cost-effectiveness acceptability curve was also plotted, and shows the proportion of simulations that are considered cost-effective at different thresholds of willingness to pay (WTP) per gained unit of QALY [ 41].
Cost-effectiveness acceptability curves reflecting the probability that pregabalin would be cost-effective (vs venlafaxine XR) at various thresholds of willingness to pay also were generated under alternative analytical scenarios.
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Subsequently, a cost-effectiveness acceptability curve (CEAC) was derived from these data [ 16] to identify which alternative would be the most cost-effective at various thresholds of willingness-to-pay (WTP) for TIX score point.
However, the use of intraprocedural CEUS resulted in better cost-effectiveness compared with the standard procedure and a higher probability of being cost-effective, with a €5755 threshold of willingness to pay.
This ratio is well above a conventional threshold of willingness to pay of £20 000-30 000 per QALY.
There is some consensus about the threshold of willingness to pay for additional QALY internationally (e.g., $50,000 in the US, £30,000 in the UK, or AUS $42,000 in Australia) [ 34].
By adopting a conventional threshold of willingness to pay of £20 000-30 000 per quality adjusted life year (QALY), we found that structured psychological therapy is a cost effective treatment for mild to moderate postnatal depression, with an incremental cost effectiveness ratio (ICER) of £17 481 per QALY versus no treatment.
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